Postoperative quality of life, satisfaction, and skin condition after varicose vein surgery

Phlebologie ◽  
2016 ◽  
Vol 45 (06) ◽  
pp. 363-369
Author(s):  
G. Bruning ◽  
A. Langenbruch ◽  
M. Augustin ◽  
W. Kath

SummaryCompression is performed postoperatively with the intention of minimising side effects, such as bleeding and haematoma in the area of operation, as well as postoperative oedema and pain. Compression stocking manufacturing has incorporated the addition of skin care products into the yarn material in recent years. However, the benefits of these products remain controversial. In addition, the length of the compression stocking is disputed in terms of its effectiveness. This effectiveness was investigated in the present study.Before surgery, 160 patients with indication of surgical removal of varicose veins were randomly divided into four groups with different types of compression stockings in each case. In each group, 40 patients received a knee-length stocking (length A–D), thigh-length stocking (length A–G), knee-length stocking with Aloe vera or thigh-length stocking with AV. At time 0 (before surgery), one week and 8 weeks after surgery, skin moisture was measured as an objective parameter, quality of life was determined using the Freiburger questionnaire of quality of life in veinous disease (FLQA-vs), benefit to patients was evaluated using the patient benefit index (PBI-v) and further subjective parameters were investigated with a free-text questionnaire. After surgery, the extent of haematoma was determined using the point count method.After surgery, at both post-operative times, the FLQA-vs decreased significantly (corresponding to a better quality of life), and the PBI-v increased. In the group with Aloe, pruritus was significantly lower, comfort and skin moisture were increased, and skin condition was significantly improved. The extent of haematoma decreased regardless of the length of the stockings.A benefit of AV as a skin care additive was observed. This finding was objectively confirmed based on the skin moisture. The multifactorial quality of life was not affected by the skin care additive. Thigh-length compression stockings did not provide a measurable benefit.

VASA ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 502-508 ◽  
Author(s):  
Thea Westphal ◽  
Wolfgang Konschake ◽  
Hermann Haase ◽  
Marcus Vollmer ◽  
Michael Jünger ◽  
...  

Summary: Background: Because of side effects like skin dryness and consecutive symptoms like itching the therapy of chronic venous insufficiency (CVI) with medical compression stockings (MCS) can lead to a diminished wear comfort and restricted compliance. Compression stockings with integrated skin care may have a positive influence on the skin hydration and moreover a positive effect on patients compliance. Patients and methods: In this monocentric, randomized prospective, controlled trial a below knee conventional MCS was compared to a medical compression stocking with integrated skin care (MCS-SC), interface pressure range 23–32 mmHg. Participants: 50 patients with CVI. Primary outcome: skin hydration. Secondary outcomes: transepidermal water loss, skin roughness, leg volume, interface pressure and questionnaires about quality of life and wear comfort. Results: In patients wearing MCS the skin moisture decreased (p = 0.021) and the skin roughness increased significantly (p = 0.001), whereas in patients wearing the MCS-SC skin moisture and skin roughness changed only slightly (n.s.). These protective effects of MCS-SC compared to MCS were most common in patients with CVI at stage 3 (p = 0.046), in male patients (p = 0.013) and patients with initial dry skin (p = 0.034). Both MCS reduced lower leg volume, MCS by 80 ml (p < 0.001) and MCS-SC by 60 ml (p < 0.001), both MCS improved quality of life: leg complaints (p = 0.0003); functional status (p = 0.010), well-being and life satisfaction (p = 0.030). Wear comfort: In terms of tightness, constriction in bond area and strenuous donning the MCS-SC was assessed significantly more comfortable than MCS (p < 0.001). Conclusions: MCS-SC revealed to be superior to MCS with regard to skin moisture, particularly in patients with low skin humidity, in male patients and in patients with C3, varicose veins accompanied by edema.


VASA ◽  
2014 ◽  
Vol 43 (4) ◽  
pp. 268-277 ◽  
Author(s):  
Christina Jeanneret ◽  
Konstantinos Karatolios ◽  
Irene von Planta

Background: Calf vein diameters during compression with two different stocking brands are assessed as well as quality of life. Patients and methods: 60 subjects (53 female) with painful legs were randomized to either wearing the Venotrain micro® (VM) or the Venotrain ulcertec® (VU) compression stocking for 2 weeks. All calf - veins were assessed in cross - sectional plane by Duplexsonography native and through the compression stockings. The diameters of 2 gastrocnemius muscle - veins (GV), the short saphenous vein (SSV) and the posterior tibial vein (PTV) were compared intra - individually, with and without compression. Results: Mean diameters (± SD) decreased significantly under compression (p < 0.0001) in the standing position: in the antero-posterior (ap) plane of the GV by 6.5 (± 16.6) % under VU and 8.2 (± 16.5) % under VM, in the SSV 9.7 (± 15.8) % under VU and 5.7 (± 19.2) % under VM. No significant change (p = 0.48) was seen in the PTV. In the prone position the relative ap - diameter changes in the medial GV were significantly smaller for the VM (37.5 ± 51.0 %) compared to the VU compression stocking (52.4 ± 51.8 %) (p = 0.016). The quality of life assessment scores improved significantly for the VU - and the VM - compression stocking. Venous diameters did not correlate with quality of life scores. Conclusions: Intra - individually tested the calf muscle vein diameters decrease under compression, more pronounced in the prone than in the standing position. In the ankle area the PTV does not decrease in standing subjects. Quality of life assessed increases for both compression stockings.


2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 18-25
Author(s):  
Alexander te Slaa ◽  
Dennis Dolmans ◽  
Gwan Ho ◽  
Lijckle van der Laan

In selected patients who suffer from severe peripheral artery disease (PAD) a revascularization with a peripheral bypass might be considered. Postoperative edema is a well-known phenomenon following peripheral bypass surgery and is probably caused by multiple factors. Although postoperative edema causes discomfort to patients, the effects on the quality of life are unknown. Treatment and preventive strategies should nonetheless aim at achieving a net absorption of fluid from the interstitial space into the vascular or lymphatic compartment. A brief summarization of treatment strategies of lower limb edema will be presented that include the use of compression stocking and intermittent pneumatic compression. So far, the postoperative application of compression stockings seem to prevent and reduce edema as much as possible. Quality of life improves slightly following peripheral bypass surgery. However, a contribution of edema on the quality of life could not be detected.


2020 ◽  
Vol 06 (02) ◽  
pp. e77-e86
Author(s):  
Anthony Pio Dimech ◽  
Kevin Cassar

Abstract Introduction One-third of adults in the United States and United Kingdom suffer from varicose veins. n-butyl-2-cyanoacrylate (NBCA) glue is a novel endovascular, nontumescent, nonthermal ablation technique for treatment of this condition. It has proved effective in multiple studies since its first use in 2013. The aim of this systematic review is to assess the efficacy of NBCA in ablating primary truncal varicose veins and eliminating reflux compared with existing endovascular techniques. Secondary outcomes include complications and quality of life. Methods PRISMA was used as a guide and studies were screened for risk of bias and methodological quality. Subjects had to be ≥18 years of age and followed-up posttreatment with color Duplex ultrasound (DUS). Eligibility criteria included saphenofemoral junction (SFJ) or saphenopopliteal junction (SPJ) incompetence with reflux down truncal veins lasting >0.5 seconds on DUS interrogation and a Clinical, Etiological, Anatomical, and Pathophysiological classification of venous disorders ranging between C1 and C6. Results Out of 2,910 patients (3,220 veins) in 17 studies, 1,981 were administered NBCA, 445 radiofrequency ablation (RFA), and 484 endovenous laser ablation (EVLA) with mean procedure times of 25.7, 23.2, and 28.7 minutes, respectively. Mean recruitment period was 9 months (1–36 months) and followed-up for an average of 12.3 months (1–36 months). The majority were C2 to C3. Two-year occlusion rates were 93.7, 90.9, and 91.5% for NBCA, RFA, and EVLA, respectively. NBCA-treated patients experienced the least complications, with bruising, phlebitis, and pain being the most prevalent. Quality of life improved equally in all three modalities. Conclusion NBCA is simple to administer, safe, and effective even without compression stockings. Further studies are required to assess longer-term benefit and the effect of anticoagulation on vein obliteration.


2017 ◽  
Vol 33 (4) ◽  
pp. 267-272
Author(s):  
Luiz Fernando Albernaz ◽  
Daiane Taís Schlindwein Albernaz ◽  
Fernanda Rita Machado Zignani ◽  
Yung-Wei Chi

Objective To analyze the outcomes of 119 (188 feet) patients undergoing foot varicose vein phlebectomy with and without sclerotherapy between 2013 and 2015. Methods Legs and feet were treated in one single procedure. Clinical and ultrasound assessments were carried out at 7, 30, and 90 days for visualization of the sapheno-femoral and sapheno-popliteal junctions and the deep vein system. Results Mean age was 50 ± 12 years (25–79 years); 67 patients were female (56.3%). Median venous clinical severity score was 4 (range 2–5) before and 1 (range 0–2) at 90 days ( p < 0.001). Edema and transient paresthesia were the most frequent complications (13 (10.92%) and 11 (9.24%) patients, respectively). All complications were resolved at 90 days except one case of edema (resolved after 150 days with compression stockings and lymphatic drainage manual therapy). Conclusions Symptomatic foot varicose vein intervention was safe and effective. Further studies should focus on assessment of vein-specific quality of life questionnaires.


2013 ◽  
Vol 75 (1) ◽  
pp. 65-71
Author(s):  
Katsuko KIKUCHI ◽  
Maki OZAWA ◽  
Setsuya AIBA ◽  
Eishin MORITA

2008 ◽  
Vol 12 (6) ◽  
pp. 268-275 ◽  
Author(s):  
Aditya K. Gupta ◽  
Richard G. Langley ◽  
Charles Lynde ◽  
Kirk Barber ◽  
Wayne Gulliver ◽  
...  

Background: Psoriasis is a chronic skin condition that can negatively affect a patient's quality of life (QoL), often hindering social functioning. ISA247, a novel psoriatic agent, has shown clinical efficacy in moderate to severe psoriasis sufferers, but its effect on QoL is currently not reported. Objective: The objective of this study was to assess the effect of ISA247 on the QoL in patients with stable, plaque-type psoriasis. Methods: A phase II, randomized, double-blind, placebo-controlled, parallel-group, multicenter study assessed the effects of ISA247 doses of 0.5 mg/kg/d ( n = 77) or 1.5 mg/kg/d ( n = 83) compared with placebo ( n = 41) for 12 weeks. QoL was assessed using the Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI) scales. Results: ISA247 treatment (pooled groups) significantly improved QoL scores as assessed by both the DLQI and the PDI compared with those receiving placebo ( p < .05). Treatment with the higher dose of 1.5 mg/kg/d demonstrated a significantly greater response to many of the QoL scales compared with the 0.5 mg/kg/d group ( p < .05). Conclusions: ISA247 appears to improve the QoL while also providing effective treatment for chronic, moderate to severe, plaque-type psoriasis.


1990 ◽  
Vol 76 (2) ◽  
pp. 101-104
Author(s):  
P. J. Shouler ◽  
P. C. Runchman

SummaryGraduated compression stockings are used in both surgical and non-surgical treatment of varicose veins. In a trial of high versus low compression stockings (40mmHg vs 15mmHg at ankle) after varicose vein surgery, both were equally effective in controlling bruising and thrombophlebitis, but low compression stockings proved to be more comfortable.In a further trial after sclerotherapy, high compression stockings alone produced comparable results to Elastocrepe® bandages with stockings. It is concluded that after varicose vein surgery low compression stockings provide adequate support for the leg and that after sclerotherapy, bandaging is not required if a high compression stocking is used.


2016 ◽  
Vol 175 (1) ◽  
pp. 11-17
Author(s):  
A. I. Kholyavin ◽  
V. B. Nizkovolos ◽  
B. V. Martynov ◽  
D. V. Svistov ◽  
A. D. Anichkov ◽  
...  

Cryosurgical method is used in treatment of patients with glial tumors which localized in depth and functionally meaningful brain areas. These patients are generally considered as inoperable and receive conservative treatment. Their prognosis has become worse as compared to the patients whose brain tumor is available for surgical removal. The authors used a multiway stereotactic destruction of tumors by cryosurgical cannula, which is inserted in bone cutter opening using manipulator. MR-imaging and PET/CT of brain were applied for stereotactic guidance. The majority of patients who underwent this operation didn’t noticed any loss of quality of life. The rates of survival were higher than corresponding indicators for patients who were treated only by chemo- or radiation therapy and the rates were equal to the patients underwent the radical operations. Thus, the multiway stereotactic cryodestruction is a new, safe and effective method of surgical treatment for the patients with tumor localization in such areas, that their location blocked an application of traditional surgical removal by open method.


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